Post-Traumatic Stress Disorders - Matar

Question 1

How do victims of traumatic events respond differently over time?

Men vs. women, Rape vs. nonsexual

Answer 1

After about six weeks non-sexual trauma victims level off at about 20% of PTSD

Male victims have 85% PTSD

40% of female rape victims have PTSD

Question 2

What is the time scale of stress-induced disorders?

Answer 2

A few days after trauma: Acute Stress Response (ASR)-physiological

After ASR up to one month: Acute Stress Disorder (ASD)

1-3 months: Acute PTSD

>3 months: Chronic PTSD

Question 3

What are the general symptoms of PTSD?

Answer 3

• re-experiencing (e.g. flashbacks, nightmares)
• avoidance (of people or situations associated with the event); interpersonal & emotional numbing
• hyper-arousal/ vigilance

Question 4

What are the diagnostic criteria of PTSD?

Answer 4

Triggering event (threat) & Response
 Intrusive Symptoms (reexperiencing, ≥ 1 of 5) ≥ 1 month
 Avoidance, withdrawal & numbing (≥ 3/7) ≥ 1 month
 Hyper-arousal/ Hyper-vigilance (≥ 2/6) ≥ 1 month
 Distress, dysfunction; no other cause likely
 (missing = Comorbidity/ Complexity)

With or Without delayed onset: Onset of symptoms at least six months after the stressor (at retirement often)

Question 5

What are risk factors of PTSD?

Answer 5

1: prior trauma (and PTSD with recovery)

• Pre-disposing (retrospective data)

Hx of anxiety/mood dis
Unstable childhood environment
Abuse & neglect
Lower IQ
Neurological soft signs (?ADHD?)
Personality variables
Genetic? Epigenetic? (HPA…)

• Peri-Traumatic

Dissociative symptoms & Dissociation
HR/HRV
Cortisol and sleep

• Post-Traumatic

Appraisal; meaning & significance
Of threat; Of events; Of symptoms

Question 6

What is the treatment for PTSD?

Answer 6

1. Serotonin Specific Re-uptake Inhibitors (SSRI) - Prozac; Seroxat; Cipramil-lex; Lustral
2. Noradrenalin Re-uptake Inhibitors (NaRI) – Edronax
3. Serotonin-Noradrenalin Re-uptake Inhibitors – Effexor (Viepax); Cymbalta; +/-Ixel

Benzodiazepines – Valium; Clonex; Xanax; Lorivan;
Mood Stabilizers – AEDs, Carbamazepine Tegretol, Valproate Valporal/Depakine, Lamotrigine Lamictal
Anti Psychotics – Risperidal; Zyprexa; Seroquel; Perphenan
Beta-blockers – Deralin; Prolol
Sexual dysfunction => Viagra, Cialis, Levitra (hi-dose CORT)

Individual, group, occupational therapy